When Wrongly Denied Is the Status Quo

Baton Rouge, LAThe disability insurance industry has long suffered from a reputation that suggests routine denials of legitimate disability claims and bad faith insurance dealings, in spite of plaintiffs and policyholders having paid their premiums faithfully and having maintained their policies in good standing. Some disgruntled consumers turn immediately to the courts through a Long term denied disability lawsuit.

Others take the advocacy route, by blogging about their issues to a like-minded audience. Looking at ConsumerAffairs.com, it becomes quickly apparent that the vast majority of bloggers riffing about their experiences with insurance provider MetLife are dissatisfied with their treatment.

Jeffrey, from Oklahoma, blogged on March 20 that when he was suddenly impacted with the need for surgery, his wife was on top of things and submitted all the necessary forms to MetLife - the insurer that provided disability coverage through his employer - the day after surgery. Jeffrey indicated that it appeared MetLife was processing his claim with due diligence, when in reality, various delays were creeping in.

Jeffrey and his wife had to resubmit their paperwork a second time, and when the claim continued to be delayed, a call to the HR department at Jeffrey’s place of employ was the only thing that succeeded in getting the claim processed with any degree of expediency.

Then there is Fran’s story. Fran is from Baton Rouge, Louisiana. She writes that her husband was covered for disability through MetLife. When he was declared permanently and totally disabled in 2012, the insurer insisted upon updated statements every four to six weeks from the man’s doctors. Paperwork, duly submitted, would become chronically lost and would need to be submitted again.

Payments sometimes arrived on time, sometimes late or missing for a few months at a time, followed by payments for back amounts owed. Fran and her husband found that such hiccups in payment frequency proved difficult in planning finances.

When it came time for long-term disability payments to kick in, Fran writes that LTD was less problematic than STD overall, but that there were still issues. For example, disability payments expected for November and December 2015 were never deposited into their checking account. There was no advance notice from MetLife that they would be doing this. In January of this year - the following month - they received a letter from MetLife indicating an overpayment, without specifics, from the years 2013 and 2014 and that [MetLife] had recovered the overage. Fran and her husband were left to assume that the missing payments for the previous two months had been used to cover the overpayment. There was no specific notification from MetLife that this had been the case.

Then, in late January, a representative from MetLife called to report that the insurer had overpaid, according to its records, $67,000 and would be looking to have the overpayment recouped. MetLife would not provide any additional details to the couple on the phone. When Fran and her husband asked for corrected tax forms for 2013 and 2014 so that they could amend their tax returns to compensate for the alleged extra income of $67,000, they were told instead that corrected tax forms would not be issued, but rather a “letter of credit” which, in MetLife’s view, would placate the Internal Revenue Service.

Other respondents on the blog had similar complaints of Wrongly Denied Disability Claims, stonewalling, delays and other examples of bad faith insurance.

Little wonder honest consumers having submitted a legitimate claim supported by expert medical opinion, and a claim made against a policy in good standing, turn to the courts and file a bad faith insurance lawsuit.